Q&A with Dr Siew Lim

Preventing diabetes and heart disease in Chinese and Indian women who had gestational diabetes: Not hard-to-reach but easy-to-ignore

Dr Siew Lim is a research fellow and Accredited Practising Dietitian specialising on health equity and women reproductive health, with a focus on gestational diabetes mellitus (GDM). She is recognised both nationally and internationally as an emerging leader in lifestyle management for women of reproductive age. Dr Lim received a 2023 Vanguard Grant for her project on integrating cultural strengths and opportunities into a cardiovascular disease and diabetes prevention program. This project aims to enhance broader translation and engagement among Chinese and Indian women who have had a history of GDM.

What are you currently researching?

Gestational diabetes mellitus affects 9-26% of pregnancies worldwide.1 Women with a history of GDM are at increased risk of heart disease and type 2 diabetes. People of non-white ethnicity face a higher risk of GDM, heart disease and type 2 diabetes. In Australia, women born in Asia have the highest rates of GDM among all birth regions. While lifestyle interventions can effectively reduce the risk of heart disease and diabetes in women with a history of GDM, our research has found lower engagement levels in prevention programs among women born overseas.

This study investigates the reasons for lower engagement in Chinese and Indian women, the largest groups of migrants in Australia experiencing GDM. We will explore how cultural and individual health beliefs affect prevention efforts and collaborate with Diabetes Victoria to co-design culturally specific resources and referral pathways. This research aims to enhance services access for the women who need it most. This will support improved service access to women who need it most.

What difference will your research make to people’s cardiovascular health in Australia?

Despite Chinese and Indian women having an unequal burden of heart disease and diabetes, the reasons for their low engagement in cardiometabolic risk reduction programs are not well understood. This project takes an innovative approach, combining principles of individual psychology, behaviour change, and organisational quality improvements to systematically describe and address disengagement in cardiovascular disease and type 2 diabetes prevention among the largest migrant groups in Australia.

What motivated you to do your research?

In the last 10 years, the number of women with GDM in Australia has tripled. Gestational diabetes mellitus significantly increases the risk of heart disease and type 2 diabetes. Women from racial minorities and those facing social disadvantage are more likely to develop these conditions. This disparity is unjust, as everyone deserves the right to good health. Unfortunately, many prevention programs fail to address these inequities. As a researcher dedicated to equity and coming from a migrant background, I am committed to addressing these inequalities to help everyone achieve and maintain good health.

Are there any achievements or discoveries from the past year you can share with us?

We have gathered insights from 100 women, and their clinicians, with a history of GDM across Australia, Asia, Africa, Europe and the US. These women identified several research priorities: stress and mental well-being, information on diet and exercise to prevent cardiometabolic disease, and lactation and breastfeeding. They emphasised that research should be accessible to everyone, based on evidence relevant to various contexts, and focused on fairness and equity.

What role has Heart Foundation funding had in your career journey?

The Heart Foundation Vanguard Grant has significantly supported my research career, specifically focusing on preventing diabetes and heart disease among women from culturally and racially minorities backgrounds in Australia. We plan to leverage this funding to secure larger grants, establishing a research platform for these priority populations who bear a large disease burden but are currently underserved.

Do you have a message for Heart Foundation supporters?

Thank you for supporting cardiometabolic disease prevention for women from culturally and racially minoritised backgrounds. This funding contributes to developing a research program for this important priority group. It also enhances my leadership career as a culturally diverse woman and enables me to contribute to reducing diabetes and heart disease within my population group.